Clinical efficacy of Xiaoying Mixture combined with glucocorticoid in the treatment of active Graves'ophthalmopathy evaluated by quantitative ocular muscle structure measurement of MRI
Objective:To observe the clinical efficacy of Xiaoying Mixture combined with glucocorticoid in the treatment of active Graves'ophthalmopathy(GO)evaluated by quantitative ocular muscle structure measurement of MRI.Methods:One hundred patients with active GO were randomly divided into the treatment group and control group,with fifty cases in each group.Both groups were treated with intravenous methylprednisolone.Meanwhile,the treatment group was orally treated with Xiaoying Mixture and the control group was orally treated with the placebo,with a course of three months.All the patients were enrolled for 3.0T MRI orbit scan before and after the treatment.Quantitative measurement of orbital structures including exophthalmos values,fatty tissue thickness of inner side in eye balls,thickness of extraocular muscles with maximum signal intensity and signal intensity ratios(SIR)of extraocular muscles to ipsilateral temporal muscles were compared before and after treatment.The clinical efficacy was observed,and the changes of NOSPECS grades and clinical activity scale(CAS)score were compared.Results:After the treatment,exophthalmos values and fatty tissue thickness of inner side in eye balls didn't obviously changed,while SIR of extraocular muscles to ipsilateral temporal muscles,thickness of extraocular muscles with maximum signal intensity decreased significantly(P＜0.05).The degree of decline in the treatment group was greater than that in the control group(P＜0.05).The clinical total effective rate of the treatment group and control group was 93.88％(46/49)and 84.00％(42/50)respectively.The clinical efficacy of the treatment group was significantly better than that of the control group(P＜0.05).After treatment,NOSPECS grades and CAS score of the two groups were improved compared with those before treatment(P＜0.05),and the improvement of the treatment group was more significant(P＜0.05).Conclusion:Compared with intravenous methylprednisolone therapy alone,Xiaoying Mixture combined with glucocorticoid can significantly improve the local inflammatory response and alleviate the clinical symptoms of patients with active GO.MRI quantitative ocular muscle structure measurement can assist in the evaluation of the efficacy of GO.
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